Abstract: FR-PO549

Evolution of Systolic Blood Pressure in the First Year of Hemodialysis: A Comparison between Tassin, France, and Renal Research Institute, USA

Session Information

Category: Hypertension

  • 1106 Hypertension: Clinical and Translational - Secondary Causes

Authors

  • Topping, Alice, Renal Research Institute, New York, New York, United States
  • Zhang, Hanjie, Renal Research Institute, New York, New York, United States
  • Raimann, Jochen G., Renal Research Institute, New York, New York, United States
  • Chazot, Charles, NephroCare Tassin Charcot, Sainte Foy-Les-Lyon, France
  • Kotanko, Peter, Renal Research Institute, New York, New York, United States
Background

Hypertension is common in hemodialysis (HD) patients. In HD patients blood pressure may be related to treatment practices. Currently the conventional HD in the US is prescribed as 3-4 hours, thrice per week. Tassin dialysis center in France performs long, 8-hour HD thrice per week and previously reported exemplary results regarding blood pressure control, fluid management, and phosphate clearance.

Methods

Patients from the Renal Research Institute (RRI) who started dialysis between 2000 and 2012 were propensity score matched to incident patients beginning HD between 2000 and 2013 from Tassin. RRI patients were matched on baseline (first week on HD) demographic, treatment and laboratory characteristics including age, sex, vascular access, dialysate and serum sodium levels and other relevant parameters. Weekly average SBP and weekly total Epogen doses (EPO) were plotted using generalized additive model over the first year of dialysis.

Results

487 RRI patients were matched from a pool of 1,914 eligible patients to an equal number of Tassin patients. Patient groups were well balanced on age, sex, diabetes and other parameters. SBP declined steadily in the Tassin group until 18 weeks on HD then continued to decrease gradually until 40 weeks on HD. RRI patients had slightly higher SBP at baseline which increased in the first 12 weeks on dialysis, then declined gradually until week 42 (Figure 1a). EPO dose increased for RRI patients in the beginning of HD until 8 weeks, then decreased steadily during the first year of HD. Patients in Tassin showed a steady decrease in EPO use over the first year of HD (Figure 1b).

Conclusion

Patients in Tassin, France who receive longer HD times showed marked decreases in SBP compared to RRI patients. Weekly EPO dose decreased in both groups, but remained much higher in RRI patients throughout the first year of HD, particularly in the first weeks of HD. Sustained higher SBP in RRI patients may be related to the higher doses of EPO.

Funding

  • Commercial Support